Impact of Health Insurance on Diabetes Health Care Utilization and Health—Evidence from Medicaid Expansion in Wisconsin/Midwest

Andrew L. Owen, PhD, MS

Research Assistant Professor,

Northwestern University

What is your presentation about?
We examine Medicaid expansion in Wisconsin and Indiana under the Affordable Care Act to estimate the causal effect of gaining insurance on health care utilization and health outcomes. We find that as patients gain insurance, their health care utilization increases for all visit types—outpatient, emergency department, and inpatient. Importantly, we also find that testing for and diagnoses of conditions such as diabetes and complications from diabetes also increases.

How do you hope your presentation will impact diabetes research or care?
Our research demonstrates the importance of access to care in the detection and effective treatment of diabetes and associated complications. We hope that this raises the salience of diabetes detection and treatment among policymakers and patients alike.

How did you become involved with this area of diabetes research or care?
I am a sociologist and research methodologist by training. I specialize in causal inference in observational settings, so working on this particular project was a natural fit for my training and skillset. I am very fortunate to work with a number of world-class experts in diabetes care and translation who have helped guide our team on this project.

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Impact of Health Insurance Churning on Diabetes Outcomes

Nathalie Huguet, PhD

Associate Professor,

Oregon Health & Science University

What is your presentation about?
Health insurance is critical to facilitate access and adherence to medication regimens as well as diabetes control and to avoid potentially life-changing complications. In a previous study we found that people with diabetes living in poverty were more likely to have periods without insurance than those without diabetes. This session will demonstrate the impact of insurance gaps on diabetes outcomes such A1C, acute complications, and medications.

How do you hope your presentation will impact diabetes research or care?
Our findings are important to inform ongoing debates regarding Medicaid and subsidies for marketplace insurance as well as the importance of supporting community health centers and programs such as the 340B to ensure adequate delivery and receipt of diabetes care.

How did you become involved with this area of diabetes research or care?
I am a health services researcher with a focus on health policies. I have been involved in the Natural EXperiments for Translational Diabetes (NEXTD) initiative for 10 years evaluating the impact of health policies on diabetes care and outcomes.

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Sugar-Sweetened Beverage Taxes and Perinatal Health—A Quasi-experimental Study

Kaitlyn Jackson, MPH

Senior Statistical Analyst,

Harvard TH Chan School of Public Health

What is your presentation about?
One in five pregnant individuals report consuming sugar-sweetened beverages at least once per day. Excess sugar consumption during pregnancy is associated with several perinatal complications. As sugar-sweetened beverage taxes become increasingly common public health measures to reduce sugar-sweetened beverage consumption, evidence of the downstream effects of sugar-sweetened beverage taxes on perinatal health remains limited. This longitudinal retrospective study found that sugar-sweetened beverage taxes in U.S. cities were associated with decreased risk of gestational diabetes and reductions in gestational weight gain.

How do you hope your presentation will impact diabetes research or care?
Nearly 50% of mothers diagnosed with gestational diabetes during pregnancy develop type 2 diabetes postpartum and remain at increased risk of heart disease. Evidence from our study suggests that sugar-sweetened beverage taxes may be an effective policy instrument for improving health during pregnancy, a critical window during which short-term dietary exposures can have lifelong consequences for the birthing person and child.

How did you become involved with this area of diabetes research or care?
I became involved in this area of diabetes research after completing my MPH at the University of California, Berkeley, and starting my role as a Research Data Analyst at the Social Policies for Health Equity Research Center (SPHERE). Over the past five years, I have spearheaded multiple analyses leveraging quasi-experimental study designs to investigate the effects of diverse programs and policies on maternal health, including gestational diabetes, gestational hypertension, and gestational weight gain.